J. Lindner, N. Nowack, W. Heckmann:
Subjective and objective changes in the care of chronically handicapped patients before and after German re-unification - shown by the example of a residential psychiatric home in the territory of the former German Democratic Republic (GDR).

In the GDR, chronically handicapped psychiatric patients
(or chronic psychiatric patients with multiple disabilities) often had to live in bed halls of huge long-term institutions. Since German re-unification the situation has been improved by newly-built decentralized complementary institutions and homes (normally with single and double rooms only). But the question is: how do the patients see their situation in respect of care and treatment retrospectively (in GDR times), and how do they see it now?
A survey was carried out with a group of 21 patients living in a home built in Salzwedel in 1995. The institution offers numerous forms of rehabilitation, including sociotherapeutic and relationship-oriented measures, in suitable rooms. All the respondents had lived as in-patients in facilities in Saxony-Anhalt before 1989, in some cases for many years. Although 72.7% felt they had been treated with respect under the GDR regime, only 9.1% said their private sphere had been respected in the past (as opposed to 81% in the new residential accommodation). 55% said they had not been allowed to participate in relevant decisions before 1989 as compared to 12.6% at the time of the study.
28.6% said they had been under "very strong" or "strong" tutelage in GDR psychiatric institutions (as against 0% in the present home). But just as many patients (28.6%) felt they had not been under tutelage at all in the GDR (and 42.9% said they did not feel under tutelage at all now).
Only 9% of the respondents said they had experienced social discrimination in the GDR. But none of the respondents felt discrimination existed now. 33.3% rated psychiatric care in the GDR as good, none as very good, and 23.8% as poor. By contrast, 61.9% rated their current situation in respect of care as very good and 19% as good; none of the patients felt it was poor.

(From a poster presentation / book for „The subjective side of schizophrenia“, 2nd conference, Hamburg, March 1 – 3, 2000 at Eppendorf University Hospital, Department of Psychiatry and Psychotherapy, Hamburg, Germany)

Dr. med. N. Nowack
Ärztlicher Leiter
Zentrum für Soziale Psychiatrie Salzwedel
Hoyersburger Str. 60
D - 29410 Salzwedel

eMail: psych-ph-saw@t-online.de

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